Surgery for Prostate Cancer

Surgery for Prostate Cancer

All-inclusive Surgery for Prostate Cancer

Tour Length: 10 Days 9 Nights

Pre-Operative

Require medical images/Initial assessment

Drink only clear fluids for a 24-hour period prior to the date of your surgery.

Clear liquid diet

Drink only clear fluids for a 24-hour period prior to the date of your surgery. Clear liquids are liquids that you are able to see through. Please follow the diet below.

Water
Clear broths (no cream soups, meat, noodles, etc.)
Chicken broth
Beef broth
Juices (no orange juice or tomato juice)
Apple juice or apple cider
Grape juice
Cranberry juice
Tang
Hawaiian punch
Lemonade
Kool-Aid
Gatorade
Tea (you may add sweetener but no cream or milk)
Coffee (you may add sweetener but no cream or milk)
Clear Jell-O (without fruit)
Popsicles (without fruit or cream)
Italian ices or snowballs (not marshmallow)

Do not eat or drink anything after midnight the night before the surgery. Aspirin, Motrin, ibuprofen, Advil, Alka-Seltzer, vitamin E, Ticlid, Coumadin, Lovenox, Celebrex, Voltaren, Vioxx, Plavix and some other arthritis medications can cause bleeding and should be avoided one week prior to the date of surgery. (Please contact your surgeon’s office if you are unsure about which medications to stop prior to surgery. Do not stop any medication without contacting the prescribing doctor to get their approval.)

Surgery

Procedure takes approximately 2½ to 4 hours

You will require a general anesthetic, which means you will be fully asleep during the surgery. The surgery can take 2-4 hours depending on the approach.

In some cases, the urologist may remove a small amount of tissue near your prostate that contains lymph nodes. This will provide information on whether the cancer has spread. One of the first places prostate cancer may spread to is the lymph nodes. Your urologist will discuss this with you before surgery.

Pre-Operative

Aftercare as standard within our packages

Pain control: You can expect to have some pain that may require pain medication for a few days and occasionally lasts for a few weeks after discharge. Afterward, Tylenol should be sufficient to control your pain in most cases.
Urinary catheter: You may have some bloody discharge around the catheter during a bowel movement. This is not uncommon and will subside. It is also not unusual to feel some increased pressure in your bladder during a bowel movement. If you see blood in your urine (not uncommon) it will help to increase your fluid intake. By increasing your fluid intake, your urine will remain diluted, preventing blood clots from forming and obstructing your catheter. Increasing your fluid intake will also help to stop the bleeding. Bloody urine is usually insignificant and resolves on its own. You may notice some leaking around the catheter when you are walking around. This can be managed through the use of Depend adult diapers or other absorbent materials. If you notice that your catheter stops draining completely, lie flat and drink a lot of water. If your catheter is still not draining after one hour you may have to have your catheter irrigated, you must notify the urology office, call the urology resident on call or visit your local emergency room. Please have the doctor at the emergency room call prior to removing the catheter.
Urinary tract infection: You may develop a urinary tract infection related to the urinary catheter (usually due to placement and catheter removal). It is important to check the clarity of your urine before the catheter is removed as well as drainage around the catheter. If you notice any urinary frequency or burning after the catheter is removed you may have an infection. It is important to call your doctor with any of these symptoms. Your doctor may prescribe an antibiotic to prevent such infections.
Showering: You may shower at home. Your wound sites can get wet but must be padded dry. Tub baths can soak your incisions and therefore are not recommended in the first two weeks after surgery. Sutures underneath the skin will dissolve in four to six weeks.
Activity: Taking walks is advised. Prolonged sitting or lying in bed should be avoided, as it can increase the risk of pneumonia and forming blood clots in your legs. If you notice any pain or swelling in your leg, chest pain (especially when deep breathing), shortness of breath, sudden onset of weakness or fainting and/or bloody sputum, please notify us immediately or go to your local emergency room. Climbing stairs is possible but should be limited. Driving should be avoided for at least one week after surgery. Absolutely no heavy lifting (greater than 20 pounds) or exercising (jogging, swimming, treadmill, biking) until instructed by your doctor. Most patients return to full activity on an average of three weeks after surgery. It is common for patients to feel fatigue or weak for a while. The length of time it takes to recover may vary.
Diet: No restrictions. Drink plenty of fluids.
Follow-up appointment: You will need to call soon after your discharge (unless arrangements were made before discharge) to schedule a follow-up visit for a cystogram, voiding trial and catheter removal to be done one week after your surgery. The Foley catheter will only be removed if your cystogram is negative
Long-term follow-up: A PSA test is required three months following surgery and at regular intervals thereafter.

Surgery for Prostate Cancer FAQs:

How long will I have the catheter after the surgery?

The catheter is removed seven days after the surgery.

How does a laparoscopic radical prostatectomy compare to open as far as the cancer cure rate?

The results of cancer control in both laparoscopic and open radical prostatectomy patients is essentially identical. This is confirmed in major institutions across the country where this procedure is being performed on a routine basis.

How long do I need to have a catheter after the laparoscopic radical prostatectomy?

For open surgery, the catheter is removed after two to three weeks. However, with a laparoscopic prostatectomy, the catheter is removed seven days after the operation. This is done in our office guided by X-ray to ensure the urethra is properly connected to the bladder.

What is the blood loss for this procedure?

The average blood loss for this procedure is about 150cc, significantly reducing the risk of blood transfusion.

Are the nerves responsible for sexual function being spared during this procedure?

Every effort is made to spare the nerves. One of the main advantages of this procedure is the fact that the nerves and vessels are all magnified and it is much easier to save them. Return of potency could take up to six months and, in some individual cases, Viagra has helped the patients.